Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Letitia Lynn Jackson, APRN-CNP

Individual provider Family Nurse Practitioner · NPI 1063812634

Letitia Lynn Jackson, APRN-CNP is a Nurse Practitioner in Pauls Valley, Oklahoma. Qualified in 2014, 12 years ago. Accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
12
Licensed in
OK
In the registry since
2014

Practice location Address checks out

2000 W Grant Ave Ste 2
Pauls Valley, OK 73075-9234
Phone: (405) 238-3900
Fax: (405) 238-3903
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 67505 (OK)

Record details

NPI number1063812634
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-CNP
Sole proprietorNo
NPI enumeratedSeptember 2, 2014
Last updated in NPPESJanuary 15, 2024
Certification dateJanuary 15, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Pauls Valley